AccountId: 011433970860
ContactId: 42e2233c-277a-45b1-b611-023c451316ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290570 ms
Total Talk Time (AGENT): 108147 ms
Total Talk Time (CUSTOMER): 110629 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/42e2233c-277a-45b1-b611-023c451316ad_20250616T12:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, calling to get eligibility of um a patient's policy.
[AGENT][POSITIVE] Yes ma'am, I can assist you with the eligibility. Um, first, can I get your name and a good call back number?
[CUSTOMER][NEUTRAL] [PII] [PII]. The extension is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] I have 02597752 M like Mary L like Larry, the number 8.
[AGENT][NEUTRAL] OK. Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], 86 of 84.
[AGENT][NEUTRAL] OK, and just let me advise you that verification of coverage does not guarantee payment of claims, um.
[AGENT][NEUTRAL] I'm sorry, and please verify the name and date of birth one more time.
[CUSTOMER][NEUTRAL] I have [PII].
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Let me get that policy number again. Somebody different came up, but I'll check it again.
[CUSTOMER][NEUTRAL] 025977.
[CUSTOMER][NEUTRAL] 52.
[CUSTOMER][NEUTRAL] M like mother, L like Lisa, the number 8.
[AGENT][NEUTRAL] OK. Yes, ma'am. Somebody different is coming up under that number. Do you have the social?
[CUSTOMER][NEUTRAL] No, I just.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I could also try to look them up by name and date of birth.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] I'm looking at the.
[CUSTOMER][NEUTRAL] Yeah, war he.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Yeah, outpatient benefits.
[CUSTOMER][NEUTRAL] OK, um, let me give you this number [PII].
[CUSTOMER][NEUTRAL] 377-52 [PII], did I give you that before?
[AGENT][NEUTRAL] No, ma'am. You gave me a different number and this looks like this is his number verify his date of birth one more time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK. Yes, ma'am. This is his policy number and just let me advise you the verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active, and you said this was for outpatient benefits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, for office visit. He's coming into the specialist office for uh ultrasound. Um, I do show that he has a primary, so I just wanted to make sure that he was covered in on a secondary basis.
[AGENT][NEUTRAL] Um, yes, ma'am. And for services, um, provided in office, including ultrasounds, we cover up to $750 per day, and that's for the coinsurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] The what is not covered?
[AGENT][NEGATIVE] The co-pay is not covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right, the co-pay is not covered. But, so, but you guys will pick up everything from the secondary from the primary, correct?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, up to $750.
[CUSTOMER][NEUTRAL] $50. OK, alright. OK. That's what I wanted to know. OK, and um that was everything that I needed is there a reference number for our call?
[AGENT][NEUTRAL] Per day. Mhm.
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII], and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] That'll be it. Thank you so much and you have a good day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Mm bye.